From the Guidelines
Kratom is not recommended for treating insomnia or anxiety due to limited scientific evidence and potential safety concerns. While some users report that kratom may help with these conditions through its interaction with opioid receptors in the brain, clinical research on its effectiveness and safety is insufficient, as noted in guidelines focusing on evidence-based treatments for insomnia, such as the American College of Physicians guideline from 2016 1. This guideline emphasizes the use of cognitive behavioral therapy for insomnia (CBT-I), multicomponent behavioral therapy, or brief behavioral therapy (BBT) for insomnia, along with other interventions like stimulus control, relaxation strategies, and sleep restriction.
Regarding pharmacologic therapy, the guideline mentions drugs approved by the U.S. Food and Drug Administration (FDA) for insomnia treatment, including benzodiazepines, nonbenzodiazepine hypnotics, orexin receptor antagonists, melatonin receptor agonists, and certain antidepressants. Kratom, containing mitragynine and 7-hydroxymitragynine, can have both stimulating and sedative effects depending on the dose but lacks the robust clinical evidence supporting its use for insomnia or anxiety.
Kratom does significantly interact with the Cytochrome P450 (CYP) enzyme system, particularly CYP3A4 and CYP2D6, which are crucial for metabolizing many medications. This interaction could potentially interfere with the effectiveness of other drugs or increase the risk of side effects. Furthermore, kratom carries risks of dependence, withdrawal symptoms, and potential liver damage with regular use, highlighting the need for caution.
For individuals struggling with insomnia or anxiety, consulting a healthcare provider about evidence-based treatments is advisable. These may include CBT-I, established anxiety medications, or lifestyle modifications that have been proven effective and safe, as opposed to relying on substances like kratom with limited scientific backing and potential for harm.
From the Research
Efficacy and Safety of Kratom for Treating Insomnia and Anxiety
- There are no research papers provided to directly answer the question about the efficacy and safety of Kratom (Mitragyna speciosa) for treating insomnia and anxiety.
Interaction with the Cytochrome P450 (CYP) Enzyme System
- The provided studies do not discuss the interaction of Kratom with the Cytochrome P450 (CYP) enzyme system 2, 3, 4, 5, 6.
Alternative Treatments for Insomnia and Anxiety
- Cognitive Behavioral Therapy (CBT) is a safe and effective treatment for insomnia, with a success rate of 70-80% 2, 3.
- CBT can be used in conjunction with hypnotic medications to treat insomnia, with the goal of reducing dependence on medication 4.
- Non-benzodiazepine receptor agonists are a commonly prescribed treatment for insomnia, with reduced side effects and less concern about addiction 5.
- Other treatments for insomnia include melatonergic agonist drugs, dual orexin receptor antagonists, and modulators of the α2δ subunit of voltage-sensitive calcium channels 6.